Retiring Arizona Prison Watch...


This site was originally started in July 2009 as an independent endeavor to monitor conditions in Arizona's criminal justice system, as well as offer some critical analysis of the prison industrial complex from a prison abolitionist/anarchist's perspective. It was begun in the aftermath of the death of Marcia Powell, a 48 year old AZ state prisoner who was left in an outdoor cage in the desert sun for over four hours while on a 10-minute suicide watch. That was at ASPC-Perryville, in Goodyear, AZ, in May 2009.

Marcia, a seriously mentally ill woman with a meth habit sentenced to the minimum mandatory 27 months in prison for prostitution was already deemed by society as disposable. She was therefore easily ignored by numerous prison officers as she pleaded for water and relief from the sun for four hours. She was ultimately found collapsed in her own feces, with second degree burns on her body, her organs failing, and her body exceeding the 108 degrees the thermometer would record. 16 officers and staff were disciplined for her death, but no one was ever prosecuted for her homicide. Her story is here.

Marcia's death and this blog compelled me to work for the next 5 1/2 years to document and challenge the prison industrial complex in AZ, most specifically as manifested in the Arizona Department of Corrections. I corresponded with over 1,000 prisoners in that time, as well as many of their loved ones, offering all what resources I could find for fighting the AZ DOC themselves - most regarding their health or matters of personal safety.

I also began to work with the survivors of prison violence, as I often heard from the loved ones of the dead, and learned their stories. During that time I memorialized the Ghosts of Jan Brewer - state prisoners under her regime who were lost to neglect, suicide or violence - across the city's sidewalks in large chalk murals. Some of that art is here.

In November 2014 I left Phoenix abruptly to care for my family. By early 2015 I was no longer keeping up this blog site, save occasional posts about a young prisoner in solitary confinement in Arpaio's jail. I'm deeply grateful to the prisoners who educated, confided in, and encouraged me throughout the years I did this work. My life has been made all the more rich and meaningful by their engagement.

I've linked to some posts about advocating for state prisoner health and safety to the right, as well as other resources for families and friends.

until all are free -

MARGARET J PLEWS (June 1, 2015)
arizonaprisonwatch@gmail.com



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Showing posts with label competency. Show all posts
Showing posts with label competency. Show all posts

Wednesday, September 12, 2012

Fascist Architecture: The "Hospital" that is still a prison.

I can't wait for the day when we tear these "masterpieces" of confinement and torture down, too. If we invested in our people BEFORE their illness brought them into the criminal justice system, instead of suspending Arnold v Sarn and erecting more prisons when things get tough, we might not have to keep rebuilding things like this...

------from correctionalnews.com------

The Un-Prison

By Ahavah Revis and Torrey Sims
(09/12/2012)
Patient rooms can hold up to two patients and include private bathrooms.Arizona State Forensic Hospital Delivers on Design and Treatment

The new Arizona State Forensic Hospital in Phoenix was designed to replace the existing 1952-built Forensic Hospital, which was comprised of 10 antiquated structures. The hospital is a secure housing and treatment facility for psychiatric patients who are found guilty of crimes but because of mitigating factors of mental illness, would not enter a state prison.

The forensic units house persons who are sent to the state hospital from the county court system. Either judged Guilty Except Insane (GEI) or to be Restored To Competency (RTC) or having been. These are persons who are found guilty of criminal behavior, but because of mitigating factors due to mental illness, they are not sentenced to a prison. A small percentage of the patients, fall under “not guilty, by reason of insanity,” which is an older verdict and no longer a current Arizona state law, but a small number remain under this sentencing.

The buildings have state-of-the-art security to protect patients, staff and visitors. The hospital is also a treatment facility and its design and programming space allows for diverse treatment options and individual-based opportunities for treatment.

The new 80,000-square-foot facility was given a budget of approximately $32.2 million, but after the project was complete it came in under budget at $24 million.

Cannon Design worked on the project, with associate principal Carl Hampson responsible for much of the design work at the facility, which opened in September 2011. Providence, R.I.-based Gilbane Building Company served as the general contractor for the construction management at-risk delivered project.

Greg McCormick, senior project executive for Gilbane Building Co., has specialized in health care facility construction for 28 years. He explained that the hospital’s security systems were unique, but the masonry construction was the same as what you would find in a traditional hospital.

Gilbane worked with the design team and the Arizona Department of Administration, which oversaw the job, to maximize the program and deliver the most beds for their budget. Through value engineering and constructability ideas, Gilbane was able to help enhance the program.

“Ultimately, we gave them 120 beds at a cost of $23.5 million, which includes soft and hard costs,” said McCormick. “The facility is high security, but the Arizona State Hospital did not want it to look like Department of Corrections project. They wanted it to look like a hospital treating patients.”
There are cameras, card readers and detention hardware throughout the structure, which includes hardened patient rooms. Norment served as the security equipment contractor and BGA as the security consultant.

As for the perimeter security, Howard Pearsall, designer of security electronics, at Norment, explained that the fence is protected with an intrusion-detection system, which was not in the original project scope. Norment’s contract, valued at approximately $1.6 million, includes the touch-screen controls to monitor movement.

Cannon Design has worked on several secure forensic hospitals in the past, but this was the first for Hampson.
“Just like any building design project that we do, you want to make them as nice as possible despite the function and restrictions that are dictated by the security and safety requirements,” Hampson said.

The facility is organized on a single level in concentric layers around a large internal courtyard. The outermost ring of these architectural “layers” includes the entry and sallyport, shared staff support, and patient bed wings — creating a secure perimeter enclosure for the compound while minimizing the need for high-security fencing, according to Cannon Design.

In the middle of the facility is a large outdoor area where patient activities and treatment options occur. The innermost “layer” of the facility is a collection of outdoor walkways, sheltered canopies and extended eaves that encircle the central courtyard and unite all building elements. In the main courtyard — the hub of the facility — a chapel is the focus of a sunken spiritual garden.

Designed around a rehabilitative mall concept of a town community atmosphere, the new facilities were planned to assist patients in training for a new daily life in a controlled environment.

Treatment Mall
The new adult civil facility consists of three patient living units: A one-story medical neural-geriatric unit and two two-story units for medical to high-acuity patients, placed along a social rehabilitation treatment “street.”

A series of courtyard spaces link the patient treatment units back to the major activities of daily life: dining areas; patient finance; library, training and education; rehabilitation activities; clothing store (donated clothing for patients); an on-site courtroom, which according to ASH is very cost-effective, in terms of staff time and safety; a barber shop; a patient-run café; a human rights office; a volunteer services coordinator; gardening areas; and special medical clinic with exam rooms, radiology, dental and audiology departments.

The comprehensive design assists rehabilitation of seriously mentally ill patients and increases the quality of life and measures of privacy and transition back into the community, explained Cory Nelson, chief executive officer (CEO) at Arizona State Hospital (ASH). “The design not only focuses on rehabilitation, but the balance between dignity and safety. We focus on the therapeutic aspects while keeping a very keen eye on safety and security.” Nelson came to ASH from South Dakota where he was a director of juvenile corrections.

He noted that a lot of states have different ways of treating this type of population. “I like the very dedicated state hospital approach, where you are doing everything you can to prepare them for release into the community and lower recidivism.” On average most patients stay from seven to 10 years.

The facility features state-of-the-art security equipment including infrared detection and security cameras throughout the hospital. Safety and Security
“The building was designed to be the barrier, with substantial fencing, but it is minimum in its look, no-climb mesh with an arched loop instead of razor ribbon,” said Nelson. “Sophisticated egress and ingress controls, as well as staff location, with alarms and radio. Communication is paramount and it is built with redundencies.”

Security components also include reinforced masonry walls as well as sealed concrete in all patient care areas or accessed areas, including treatment areas, therapy areas and bed wings. The site is also contained with high fences covered in “no climb” mesh screening. The entire facility, including all rooftop areas is monitored by an extensive state-of-the-art security system consisting of cameras and infrared detection

The state originally wanted a 200-bed facility, but after the budget was determined and a cost-model was developed, it realized it could only afford 80 beds, according to Hampson. However, because the design came in under budget, it was able to build an additional 40 beds. The facility now has a total of 120 beds, but the master plan still gives the facility room to grow, with the ultimate goal of 200 beds in the future.

“The cost and budget were low, so to try to make something pleasant for the staff and the people who are going to be occupying the facility, while working on a very low budget, was a challenge,” Hampson explained. “We wanted to make something that was more of a healing type of environment than a prison environment. The purpose for the facility is rehabilitation and not incarceration.”

The design and construction of the new specialized, high-security facility provides 120 patient rooms with adequate support areas including isolation rooms, multi-purpose rooms, centralized nursing stations, which allow clear views of patient areas, meeting rooms, testing and evaluation areas, visitors center, kitchen/dining, security control and command center, therapy areas and sallyport.

The Forensics Hospital was not only built on the occupied Arizona State Hospital campus, but directly adjacent to and surrounded by an active Arizona Department of Corrections facility. Security throughout the project was considered paramount in order to ensure that at no time the facilities security or ability to deliver patient care would be diminished or compromised. The new facility consisted of the construction of nine new buildings along with the interior demolition and renovations of a single-story existing office building on the Arizona State Hospital campus. These buildings were made up of six patient bed units, a two building therapy mall and a master control/security building. One of the primary bed units is designated as intensive care unit (ICU) in order to treat and hold the most abusive patients as well as provide for the initial analysis and observation of incoming patients.

Each of the buildings needed to be constructed out of the most secure, hardened materials possible. The exterior walls are constructed out of 12-inch concrete masonry unit (CMU) which have internal cells filled with solid grout and spray foam insulation in order to obtain the required R-value.

All patient areas within the buildings have reinforced masonry walls with epoxy paint. To provide safety protection for all patients and staff, Lexan panels were installed at all interior glazing and in all exterior one-inch insulated units. All floors in the patient care areas or accessed areas including the treatment areas, therapy areas and bed wings consist of sealed concrete. All nursing rooms and patient rooms have painted drywall ceilings, which have been installed at 10 feet to provide for an aesthetically pleasing space that created a more comfortable environment and feel for the patients.

All nonpatient care areas, support spaces, offices and conference areas have drywall partitions with acoustical ceilings and vinyl composition tile (VCT)/carpet finishes.

The roof structure consists of 8-inch hollow core concrete planks with a membrane roof. Each building has its own rooftop HVAC system to provide for flexibility and service. The site is contained within 12-feet high fences covered in “no-climb” mesh screening. The entire facility, including all rooftop areas, is monitored by an extensive state-of-the-art security system consisting of cameras and infrared detection.

Green Strategies
The facility was designed to suit the Arizona climate with a large focus on water and energy reduction, including installations of low-flow toilets and using recycled materials during construction. The hospital promotes a Zen-like atmosphere to help with healing and rehabilitation. Since the project was on a tight budget, designers had to utilize space as efficiently as possible.

“The most important part of this is that these kinds of facilities should be treated just like any other architecture, and they should be humane environments, include natural lighting, respond to the environment where they are, which this does — being a very harsh summertime environment — and they should provide a degree of calm and order by creating a quality space, rather than creating something that’s harsh and unpleasant to be in,” Hampson said.

Other green design strategies include incorporating 12-inch concrete blocks with integral insulation in order to provide substantial protection from the heat, while offering appropriate durability, inside and out, according to Hampson. The facility is also north facing with full-height glazing at patients’ day rooms; includes broad roof overhangs at the therapy mall; exterior circulation that reduces cooling loads; highly reflective roofing that reduces heat gain; and drought-resistant landscaping.

Patients at the facility are housed in secure beds where each room accommodates up to two patients and includes private bathrooms. The facility’s commitment to sustainability led the design team to complete a “self-certification,” where they found the energy-efficient design and installations at the facility would have them achieve LEED silver, although they will not be going towards official certification by the U.S. Green Building Council due to a client policy.

The outdoor space was designed with the Arizona climate in mind, focusing on elements that could be maintained given the harsh summertime environment.

Project Data
Construction Budget: $25 million
Number of Beds: 120
Area: 104,000 square feet
Start Date: September 2009 (groundbreaking)
Completion Date: May 2011
Owner/Operator: Arizona Department of Administration
Owner Representative: Roger Berna
Project Managers: Tom Goderre/Greg McCormick
Architect: Jacobs Carter Burgess/Cannon Design
Structural Engineer: Paragon Structural Design
Mechanical Engineer: Jacobs Engineering
Construction Manager at-Risk: Gilbane Building Company
Security Electronics Contractor: Norment
Security Electronics Consultant: Buford Goff & Associates

Product Data
Panic Devices: Von Duprin
Closures: LCN
Handles: CDDSK
Handles and Thumb Turns: Schlage
Locksets and Mortise Cylinders: Corbin/ Russwin
Door Position Switches and Electric Jamb Locks: Southern Steel
Weather Stripping: National Guard
Cameras: Viacon
Switches in Power Supplies: Cisco
Monitors: Dell
Touch Screens: ELO
Card Readers: ESX
Paging Amplifiers: TOA
Shatter-Proof Windows: Lexan
High-Security Light Fixtures: Kenall
Shatter Proof Light Switch Cover Plates: Hubble

Tuesday, December 13, 2011

Restoring prisoners to competency in Yuma County.

I'd rather see more programs diverting the seriously mentally ill from prosecution altogether...but this has an interesting design that includes education about the legal process and seems worth posting. Hopefully they won't take as long with folks as Maricopa County (MCSO) does (9 months seems the norm here) - that's a long time to lock a person up in a place like that who hasn't even been to trial, and seems only to coerce too many into pleading guilty as soon as they're deemed competent to in order to get out of MCSO custody, the jail's treatment of the SMI is so bad.

We wish the best to Dr. Falcon with this program - we hope it serves Yuma County's vulnerable prisoners well. Anyone who has direct experience with this program and thoughts on it is invited to contact me (Peggy) at arizonaprisonwatch@gmail.com. I'd love to hear how it's going. Same with any of the restoration to competency or mental health programs in Arizona's other county jails.


---from the Yuma Sun---


Jail starts program to restore suspects to competency

http://www.yumasun.com/news/program-75148-person-trial.html

After months of planning, the Yuma County Detention Center has implemented its own restoration to competency (RTC) program.

YCDC recently held an open house to show local judges a newly renovated mental health pod and to explain how the RTC program works.

When a person who is charged with a crime is determined by a judge to be incompetent, the judge places him or her into a mental health program so treatment can be administered until the person is capable of standing trial.

“Before we sent everyone who couldn't stand trial to the Arizona State Hospital or to another county with an RTC program,” said Lt. Joe Lackey. “Now instead of sending them away, everything is going to be performed here at the local jail. (Often times,) it would take a year before a person was restored...and that is very expensive. So this will definitely save the county money.”

Yuma County's RTC program focuses on both teaching the person what will happen during the trial and treating the person's mental illness.

“One of the things we emphasize is that it's a process,” said Dr. Elizabeth Falcon, the program's head forensic psychologist. “They first go through intake assessments, which allows us to target the areas they need to work on. Once we identify those, they begin the other critical part which is the education piece. Also during this time, they are receiving the treatment that they need.”

Falcon said the education component is divided into a series of 12 modules and the inmates must pass each one before advancing in the program.

“The modules are curriculum-based and are multi-modal so they are not just doing the same lesson,” she said. “Some (modules) include exercises or role-playing while others are more traditional.”

After inmates finish the modules and complete their therapy, they partake in a mock trial which prepares them for the actual courtroom.

“We try to simulate every aspect of a trial,” Falcon said. “Everybody who participates has a script and then we act out the trial just as it would in the courtroom.”

Two people have been admitted to the program since its inception in early November, with one person successfully completing it.

“I think it's wonderful that we have this program in Yuma,” said Yuma County Superior Court Judge Maria Elena Cruz. “It expedites the process so we can quickly identify those that can be restored and those that can't. So it's a cost savings not only financially, but on the human side of it because we won't have someone who is mentally ill without the possibility of being restored being held for months and months in jail.”



Thursday, September 23, 2010

The restoration of Jerry Kulp.



I looked and looked this week for memories in the ether from Jerry Kulp's short life. All I could find were his court and ADC papers. Jerry was a 17-year old prisoner on the Minors Unit at ASPC-Tucson last May when he committed suicide.


Jerry hadn't even been in prison a week; he must have just been terrified.
How could anyone on the Minors Unit miss all the signs he must have been broadcasting that he wasn't going to last long inside?


Jerry wasn't a gang member, from what I can tell. He was a seriously mentally ill child.he was only 15 when he was charged as an adult, and Jerry was so mentally impaired at the time that he required a guardian to make his legal decisions for him, and had to undergo several rounds of competency exams and "restoration treatment" in Joe's Jail over the course of 6-9 months to be fit for trial.


Does anyone else out there find that troubling? There seems to be a pattern here with mentally ill people being inappropriately prosecuted - kept in jail the whole time their trials are being postponed - (as if they already know that they're guilty and doing the time anyway) - while they medicate them into health. Once so restored, they promptly plead guilty and get sent to prison where they end up neglected or assaulted and killed.

I can't believe we prosecuted a mentally incompetent child as an adult, and then threw him into prison, but I guess we do that all the time. That can't possibly be legal. Why was this kid sent to prison instead of to a hospital, anyway? To teach him some kind of lesson? He seems to have suffered plenty enough. To scare the rest of us at his expense? No wonder we're so soul sick.


I'd like to speak to Jerry's friends and family, if you're out there. Some of us are organizing to make sure this doesn't keep happening to people like Jerry and me in Arizona's state prisons. My phone number is 480-580-6807. My email is prisonabolitionist@gmail.com. Peggy Plews.

Monday, May 3, 2010

RULE 11: Maricopa County, AZ Legislature, and Competency.

An informative - and troubling - reprint from the Winter 2007 journal issue of "CorrectCare," by the National Commission on Correctional Health Care. People should not be so brutalized for having a mental illness and being too poor to bond out to see a private shrink. We're far too casual about stealing chunks of people's lives like that - it's as if we assume that because they're mentally ill and/or poor their time is of no value to them, their community, or their families anyway - as if their lives have no value, essentially.

THAT's criminal.


This article came out three years ago, by the way - before the county jails lost their health care accreditation. And we know that mental health services in this state just took a huge hit. What a bunch of short-sighted, self-interested idiots we have in the legislature, "saving" our money by selling both our public property and our people's welfare to the highest bidder.

Expect the jails and prisons to swell even more folks - we're going to pay a hell of a lot more to store people there than we would have to treat them in the community or hospital and assure that they have housing (one big reason people are arrested for trespassing is lack of their own home and bathroom).

So much for our government's commitment to keeping us "safe" - it's the Arizona state government we're most endangered by now. Perhaps some of them should be detained for competency hearings...I have an idea of who to start with.

Those of you who have more recent experience with Rule 11, please contact us so we can make sure others are informed on current conditions.


----------------------------

Restoring Competency: One County’s Solution
By Lindy Funkhouser, JD

In the spring of 2003, Ruben D.* appeared in a Maricopa County Superior Court room. Ruben was chronically mentally ill. His illness got particularly bad one day, leading to an arrest for disorderly conduct and trespassing. Ruben couldn’t make the $300 bail so he had to remain in jail until the court disposed of his charges.

On this day, after Ruben had spent about 60 days in jail, he and 15 other inmates were pulled from their cells to attend 2 ½ hours of a court calendar for defendants with “legal competency” issues. Some months ago, Ruben’s attorney had asked the court to evaluate his ability to understand his charges and to assist in his defense. In Arizona this is called a Rule 11 evaluation, for the Arizona Criminal Rule of Court that governs competency determinations.

In the Maricopa County justice system, Rule 11 was so well-known that it became a colloquial expression, as in “My attorney said I should go Rule 11 to see if it can get me off [criminal charges].” Unfortunately, Rule 11 was not a promising environment for Ruben or anyone else unlucky or gullible enough to be there. Think of George Orwell’s “1984” or Lewis Carroll’s “Alice in Wonderland.”

You see, Ruben’s attorney triggered a cumbersome and lengthy evaluation process. Ruben had to wait in jail for a court-appointed expert to prescreen him and determine whether he was appropriate for an evaluation. In other words, Ruben had to wait for an evaluation of competency to determine whether he needed an evaluation for competency. Chalk up at least 7 to 10 days for the prescreen evaluation.

As in about 75 percent of all referrals, the prescreen evaluation showed that Ruben needed to be evaluated for competency. This meant that Ruben had to wait for the court to schedule a status conference and appoint a psychiatrist and psychologist to perform a full Rule 11 evaluation. At that time in Maricopa County, the evaluators were contract providers who would arrange to meet with Ruben, review his records and write a recommendation to the court. Add another 60 to 90 days for the recommendation to land on the court’s desk.

Three Possible Findings
A competency evaluation typically leads to one of the following three recommendations:

1. Competent. This finding would mean Ruben was capable of understanding his charges. The court would assign his cases back to a trial judge without any further evaluation.

2. Incompetent/restorable. This finding would mean that although Ruben was not capable of understanding his charges, his condition was treatable. In the spring of 2003, this would mean committing him for treatment at the Arizona State Hospital.

3. Incompetent/not restorable. This finding would mean that Ruben was not capable of understanding his charges and that he could not be treated or “restored” to competency.

The evaluators in Ruben’s case picked not one but two of the recommendations; one said he was incompetent/not restorable and the other said he was incompetent/restorable. This meant that Ruben had to wait for a third evaluation, a tiebreaker. This drastically delayed Ruben’s case, adding about 45 to 60 days to his stay in the jail.

By this time, Ruben had waited in line for the court to consider the prescreen report, appoint the initial evaluators and then appoint a third evaluator. In all, Ruben had to wait six months before the court could determine whether he needed competency restoration treatment. Already, Ruben’s incarceration was longer than his likely sentence for disorderly conduct and trespassing.

The tiebreaker evaluation found Ruben was incompetent but restorable. The court promptly committed Ruben to be treated at the Arizona State Hospital.

But Ruben would not be treated soon. His name was placed on a list of 50 inmates who were waiting for an open bed to commence treatment at the hospital. This meant Ruben would likely wait another 60 to 90 days.

State Hospital was no picnic for mentally ill patients like Ruben. The hospital did not classify or restrict mobility of inmates based on their dangerousness or the nature of their charges. Ruben would be placed in the same dormitory setting as dangerous inmates who had skillfully faked a mental illness to avoid trial and sentencing. These patients occasionally attacked and injured other inmates and hospital staff.

Treatment at State Hospital was expensive. The average cost to restore a Maricopa County inmate was about $30,000. Multiply that cost by 250 inmates for the fiscal year and the full cost for Maricopa County restorations was $7,500,000.

The county had been relatively indifferent to this cost because the state paid half of the bill. But the 2003 legislature decided to eliminate the subsidy to make up for shortfalls in the state budget. In the 2004 fiscal year, Maricopa County projected that 300 inmates would need restoration services. This demand, coupled with elimination of the state’s subsidy, threatened to increase Maricopa County’s costs by $5,750,000.

Exploring the Concepts
Many excellent articles and legal opinions have explored and debated the concepts involved in legal competency. The authorities generally agree that legal competency concerns certain fundamental rights in the United States judicial system. For example, a defendant accused of crime is entitled to competent counsel under the Sixth Amendment to the Constitution. This right to effective assistance of counsel means very little if the defendant is mentally incapable of using that counsel in the criminal case. Also, the Sixth Amendment provides that a defendant is entitled to know the nature of her charges. This right is meaningless if the defendant is mentally incapable of understanding her charges.

The Sixth Amendment also guarantees the accused the right to a speedy and public trial. This typically means that the court must meet legal deadlines to resolve the criminal trial as expeditiously as possible.

But speedy trial rules do not apply to a competency determination. So unless the courts and policy makers address competency in a timely manner, incompetent jail inmates will be effectively disenfranchised. Justice will be denied for the inmate who, like Ruben, is charged with a minor offense, needs mental health treatment and is unable to advocate for better treatment. All of this would happen for the cause of protecting Ruben’s constitutional rights. In such cases, justice resembles “Alice in Wonderland” and courts do not like it.

Award-Winning Solution
The Maricopa County Board of Supervisors addressed the problem on June 15, 2003, and provided funds to restore inmates in the county jails. County staff established a forensic team within the Department of Correctional Health Services (CHS) composed of a psychiatrist, psychologist and three masters-level social workers.

The county developed working relationships with the county sheriff, superior court and public defenders. The presiding judge of the Superior Court authorized CHS to restore inmates on the State Hospital waiting list and worked with CHS to change court forms.

CHS implemented the Restoration to Competency (RTC) program on August 15, 2003, less than 60 days after funding by the Board of Supervisors. Social workers contacted each inmate, performed a psychosocial workup and administered a preliminary competency examination. A psychologist met each inmate and evaluated the inmate’s condition. The program employed standardized tests to identify the inmates’ cognitive deficits and strengths. The team used this information to develop a restoration plan tailored to each inmate’s needs.

In the early months of the program, the forensic team used jail staff psychiatrists to prescribe medications. The forensic team met weekly to review and discuss all the cases, assess each inmate’s progress and make adjustments to the restoration plan. By October, staff began attending all court competency proceedings to keep court communication at maximum levels. This process kept the staff up-to-date on all time-sensitive matters.

By late November, the program hired a psychiatrist and added a psychologist and three masters-level social workers to increase the program’s capacity.

By December, the program had diverted 63 cases from the hospital, saving the county more than $2,000,000. The waiting list shrank from 67 inmates in November 2003 to 38 in January 2004. Waiting time for treatment decreased from 90 days to less than 60 days.

By July 2004, Maricopa County assumed virtually all restoration cases and brought all restoration costs under budget, including costs of State Hospital admissions. The Maricopa County RTC program received a National Association of Counties 2004 Achievement Award “in recognition of an innovative program which contributes to and enhances county government in the United States.”

The Maricopa County RTC experience suggests that an organization can adopt innovative solutions to manage and control its costs. Providing services in the jail allowed the county to implement management strategies that improved timeliness and effectiveness of the services. It proved that customized services for the mentally ill could be cost-effective.

In the meantime, the rights of inmates, like Ruben, are better aligned with the spirit of the law.

* This person is fictional.

About the author: Lindy Funkhouser, JD, is the director of Maricopa County Correctional Health Services, Phoenix, AZ.

[This article first appeared in the Winter 2007 issue of CorrectCare.]